META ANALYSIS OF PAIN SYMPTOMS IN ADOLESCENT NON SUICIDAL SELF-INJURY PATIENTS BASED ON NEUROIMAGING FEATURES

Abstract Objectives A meta-analysis was conducted on pain symptoms in adolescent patients with Non suicidal Self Injury (NSSI) based on neuroimaging features. Methods Using platforms such as CNKI, Wanfang, Web of Science database, PubMed, etc., reference literatures covering neuroimaging features, non-suicidal self-injury behavior in adolescents, and pain symptoms were screened, and a subsequent meta-analysis was completed. In the study, a total of 20 articles met the research criteria, and subsequent meta-analysis was conducted using Stata 17.0 software. Results This study included 20 studies (with a total sample size of 3062). Meta-analysis showed that pain symptoms in adolescent NSSI patients were significantly associated with four types of neuroimaging features: (1) Structural abnormalities (such as reduced volume of insular gray matter associated with dissociative pain, SMD = -0.82); (2) Abnormal functional connectivity (such as enhanced anterior cingulate gyrus amygdala connectivity associated with pain tolerance, β = 0.43); (3) Metabolic/activation abnormalities (such as decreased hypothalamic occipital metabolism associated with delayed pain, AUC = 0.75); (4) Neurobiochemical abnormalities (increased levels of Gamma-aminobutyric acid (GABA) in the prefrontal cortex are associated with pain threshold, β = 0.47). The analysis showed high heterogeneity (I2 = 78.2%, p<.001). Conclusions The pain abnormalities in adolescent NSSI patients have a clear neuroimaging basis, involving structural and functional disorders of pain processing networks (insula, anterior cingulate gyrus, etc.), as well as dysregulation of emotional regulation pathways (prefrontal-limbic system), providing a neural mechanism explanation for symptoms such as pain numbness and dissociation. In the future, large sample longitudinal studies are needed to overcome heterogeneity limitations and promote precise interventions based on neural targets.